Talk to General Physician on Fracture Of Right Thumb

A 28 yr old labourer with a history of multiple fractures of lower limb was presented with swollen thumb. he was pushing a cart on a ramp,disbalanced and crushed his thumb between the cart and pole. he fainted after a while at the spot,got his xray done the next day,dr has only dressed his thumb with just a normal dressing no plaster of paris cast. I am attaching the pic and the medicines prescribed by the doctor. the patient is still in severe pain and couldn't sleep from 2 nights. please tell if he needed any surgery or cast. and how to reduce the pain